R. Green compares two-spirit peopwe, hijra, mukhannadun, and kadoey, aww of which are peopwe assigned mawe at birf who have adopted a more feminine gender rowe.[10] They have in common earwy effeminacy, aduwdood femininity, and attraction to mascuwine mawes.[11] Green argues dat de members of dese groups are mentawwy indistinguishabwe from modern western transsexuaw women, uh-hah-hah-hah.[10]

The exact cuwturaw rowe of two-spirit peopwe varied from tribe to tribe, but in aww cases Green writes about dey are oriented towards men, uh-hah-hah-hah.[10]

Mukhannadun were transgender individuaws of de Muswim faif and Arab extraction who were present in Medina and Mecca during and after de time of Muhammad.[13] Ibn Abd Aw-Barh Aw-Tabaeen, a companion of Aisha Umm uw-Mu'min'in who knew de same mukhannaf as Mohammed, stated dat "If he is wike dis, he wouwd have no desire for women and he wouwd not notice anyding about dem. This is one of dose who have no interest in women who were permitted to enter upon women, uh-hah-hah-hah."[14] That said, one of de Mukhannaf of Medina during Muhammad's time had married a woman, uh-hah-hah-hah.[13]

Travesti are Braziwian trans women who are attracted to men, uh-hah-hah-hah.[15] Travestis' feminine identity incwudes hormones and/or siwicone body awterations, feminine dress, wanguage, and sociaw and sexuaw rowes, but rarewy genitaw surgery.[15] However, in contrast to Norf American transgender women, dey often don't see demsewves as reaw women, and many describe demsewves as gay or homosexuaw.[15] According to Don Kuwick, dey wiww describe demsewves instead as "feewing wike a woman".[15] In his book Travesti: Sex, Gender and Cuwture among Braziwian Transgendered Prostitutes, he writes dat no travesti in Sawvador ever cwaims to be muwher (a woman) except as a joke, and travestis reading or hearing about transgender peopwe who say dey feew wike women regard dem as disturbed.[16]

Foerster reported a 15-year successfuw rewationship between a woman and a trans man who transitioned in de wate 1960s.[22][23]

In de 20f century, trans men attracted to women struggwed to demonstrate de existence and wegitimacy of deir identity.[24] Many trans men attracted to women, such as jazz musician Biwwy Tipton, kept deir trans status private untiw deir deads.

Audor Henry Rubin wrote dat "[i]t took de substantiaw efforts of Lou Suwwivan, a gay FTM activist who insisted dat femawe-to-mawe transgender peopwe couwd be attracted to men, uh-hah-hah-hah."[24]Matt Kaiwey, audor of Just Add Hormones: An Insider’s Guide to de Transsexuaw Experience,[25] recounts his transition "from 40-someding straight woman to de gay man he’d awways known himsewf to be."[26] Researchers eventuawwy acknowwedged de existence of dis phenomenon, and by de end of de 20f century, psychiatrist Ira Pauwy wrote, "The statement dat aww femawe-to-mawe transgender are homosexuaw [Pauwy means attracted to women] in deir sexuaw preference can no wonger be made."[20]Gay trans men have varying wevews of acceptance widin oder communities.[27] For some gay trans men, dey find having sex wif cisgender gay men to be a powerfuw vawidation of deir identity as gay men, uh-hah-hah-hah.[citation needed] Upon beginning testosterone treatments, some trans men report an increase in bof deir wibido and deir desire for sex wif non-trans men, uh-hah-hah-hah.[28]

Tobi Hiww-Meyer, sewf-described 'Queer Trans Muwtiraciaw Sex-Positive Activist Writer and Porn Maker', is making a documentary cawwed Doing it Again: In Depf about transgender peopwe's sexuawities. As of December 17, Vowume 1: Pwayfuw Awakenings has been reweased.[30] This vowume interviews coupwes where bof peopwe are transgender. Cuwturaw studies schowar J.R. Ladam wrote de first definitive anawysis of trans men's sexuaw practices in de journaw Sexuawities.[31]

Sexowogist Magnus Hirschfewd first suggested a distinction based on sexuaw orientation in 1923.[36] A number of two-type taxonomies based on sexuawity have subseqwentwy been proposed by cwinicians, dough some cwinicians bewieve dat oder factors are more cwinicawwy usefuw categories, or dat two types are insufficient.[37] Some researchers have distinguished trans men attracted to women and trans men attracted to men, uh-hah-hah-hah.[38][39]

In 1974, Person and Ovesey proposed dividing transsexuaw women into "primary" and "secondary" transsexuaws. They defined primary transsexuaws as asexuaw persons wif wittwe or no interest in partnered sexuaw activity and wif no history of sexuaw arousaw to cross-dressing or cross-gender fantasy.[41] They defined bof homosexuaw and transvestic transsexuaws to be secondary transsexuaws.[42] Later uses of dis terminowogy often defined primary transsexuawism as attracted to mawes, and secondary transsexuawism as attracted to femawes.

In de DSM-III-R, reweased in 1987, "transsexuawism" was divided into "homosexuaw" and "heterosexuaw" subtypes.[43]

A 5 type sexuaw orientation scawe has never been proposed and dat shouwd be viewed as probwematic especiawwy wif de adoption of de transgender umbrewwa and its LGBT attachment. Dr Norman Fisk [44] noted dose entering his cwinic seeking reassignment surgery comprised a warger group dan fit into de cwassicaw transsexuaw diagnosis. The articwe notes dat effeminate gay men and heterosexuaw fetishistic transvestites desire surgery and couwd be considered good candidates for it. He bewieved dey couwd successfuwwy integrate after surgery. This points to probwems wif transsexuaw sexuaw orientation research dat onwy recognizes two groups. This indicates dere are two groups for sexuaw attraction to men in Transsexuaw women, uh-hah-hah-hah. One from a homosexuaw perspective and one dat shouwd eider match or be simiwar to dat of a heterosexuaw woman, uh-hah-hah-hah. There wouwd awso be two types for transsexuaw men, uh-hah-hah-hah. A fiff group wouwd exhibit extremewy fetishistic behavior and be bisexuaw onwy whiwe cross dressed before transition or excwusivewy heterosexuaw. This means of de five groups onwy dree wouwd be potentiawwy totawwy comfortabwe wif pwacement widin de gay community and for one group each from de mawe and femawe side it wouwd be conversion derapy.

The DSM had a diagnosis of transvestic fetishism.[45] Some derapists and activists sought to de-padowogize dis category in future revisions.[46] DSM 5, which was reweased in 2013, repwaced de transvestic fetishism category wif 'transvestic disorder'.[47]

Fowwowing de exampwe of de Benjamin Scawe, in 1979 Buhrich and McConaghy proposed dree cwinicawwy discrete categories of fetishistic transvestism: "nucwear" transvestites who were satisfied wif cross-dressing, "marginaw" transvestites who awso desired feminization by hormones or surgicaw intervention, and "fetishistic transsexuaws," who had shown fetishistic arousaw but who identified as transsexuaws and sought sex reassignment surgery.[48]

This section needs expansion. You can hewp by adding to it.(June 2010)

Sexuaw behavior and gender rowes vary by cuwture, which has an effect on de pwace of gender variant peopwe in dat cuwture. In most cuwtures, transsexuaw peopwe are stigmatized, and sexuaw activity invowving transgender peopwe is considered shamefuw, especiawwy in cuwtures wif rigid sex rowes or strictures against non-heterosexuaw sex.

In African-American and Latino cuwtures, a distinction is sometimes made between active and passive sexuaw activity, where de passive or receiving partner is not considered mascuwine or straight, but de active partner is.[49][citation needed]

Some observers qwestion de racist assumptions behind cwinicaw witerature on transgender sexuawity in various ednic groups.[who?]

Some Asian countries, notabwy Thaiwand, have a more sociawwy towerant view of transgender sexuawity.[citation needed]

In many cuwtures, transgender peopwe (especiawwy trans women) are freqwentwy invowved in sex work such as transsexuaw pornography.[citation needed] This is correwated wif empwoyment discrimination, uh-hah-hah-hah. In de Nationaw Trans Discrimination Survey, 11% of respondents reported having done sex work for income, compared to 1% of cisgender women in de US.[50] According to de same survey, 13% of transgender Americans are unempwoyed, awmost doubwe de nationaw average.[51] 26% had wost deir jobs due to deir gender identity/expression, uh-hah-hah-hah. Transgender sex workers have high rates of HIV. In a review of studies on HIV prevawence in trans women working in de sex industry, over 27% were HIV positive. However, de review found dat trans women engaged in sex work were not more wikewy dan trans women not engaged in sex work to be HIV positive.[52] Studies have found dat in de United States HIV is especiawwy prevawent amongst transgender sex workers of cowor, particuwarwy bwack trans women, a probwem dat has been identified by academics[53] and members of de transgender community.

The subject of transgender sex workers has attracted attention in de media. Paris Lees, a British trans woman and journawist, wrote an articwe in June 2012 for de Independent defending criticism of Ria, star of Channew 4 documentary Ria: Teen Transsexuaw, who was seventeen at de time and depicted as working as a prostitute at a massage parwor, saying dat de choice to engage in sex work is a matter of bodiwy autonomy and pointing out reasons dat young trans women often turn to sex work such as wow sewf-esteem and severe empwoyment discrimination, uh-hah-hah-hah.[54] A review by GLAAD of its archives of transgender-incwusive tewevision episodes from 2002 to 2012 found dat 20% of transgender characters were depicted as sex workers.[55]

^Wahng SJ (2004). Doubwe Cross: Transamascuwinity Asian American Gendering in Trappings of Transhood. in Awdama AJ (ed.) Viowence and de Body: Race, Gender, and de State. Indiana University Press. ISBN0-253-34171-X "Thus de institutionawized recognition of de qweer-identified, or homosexuaw, transsexuaw, is historicawwy groundbreaking. Rosario scrutinized how transgenderism has been described in rewation to homosexuawity and heterosexuawity in bof de revised dird edition and de fourf edition of de [DSM]. In de DSM-III-R, de cwassification of "transsexuawism" was divided into "homosexuaw" and "heterosexuaw" subtypes. However, sexuaw orientation was based on one's birf sex, so dat an FTM who was attracted to women wouwd be deemed a femawe homosexuaw transsexuaw, whereas an FTM attracted to men wouwd be considered a femawe heterosexuaw transsexuaw. These diagnoses were especiawwy confusing since a femawe homosexuaw transsexuaw – dat is, an FTM who desires women – wouwd actuawwy identify himsewf as a heterosexuaw trans man, uh-hah-hah-hah. And an FTM who desires men, a femawe heterosexuaw transsexuaw, wouwd sewf-identify as eider a gay man or a qweer-identified FTM."